Abstract：
A retear after rotator cuff repair is a common problem; however, there is little information related to the prognosis after a retear. In addition, some patients with retears have satisfactory outcomes, which raises the question of whether a retear leads to a poor prognosis.
To identify radiological factors that influence the prognosis after a retear.
Case-control study; Level of evidence, 3.
A total of 51 patients with retears confirmed by magnetic resonance imaging at 1 year after arthroscopic rotator cuff repair with a minimum follow-up of 24 months were enrolled in this study. Patients were divided into 2 groups according to whether they achieved the minimal clinically important difference for clinical outcome measures. Range of motion and radiological variables, including preoperative and postoperative anteroposterior (AP) and mediolateral (ML) tear sizes, sagittal extent of the retear, acromiohumeral distance (AHD), and degree of fatty degeneration, were analyzed using magnetic resonance imaging.
Overall, 36 patients were allocated to the good prognosis (GP) group and 15 to the poor prognosis (PP) group. The 2 groups had no significant differences in baseline demographics and preoperative radiological parameters. Postoperative range of motion was decreased in the PP group at the last follow-up. The AP and ML retear sizes decreased in both groups after arthroscopic rotator cuff repair, but the retear size was significantly larger in the PP group (both P < .05). The AHD increased in the GP group (P < .001) but decreased in the PP group (P = .230) postoperatively. Logistic regression analysis revealed that postoperative AHD (P = .003), fatty degeneration of the infraspinatus tendon (P = .001), posterior (P = .007) and anterior (P = .025) sagittal extent of the retear, and change in the AP tear size (P = .017) were related to poor outcomes after a retear. However, change in the ML tear size (P = .105) and middle sagittal extent of the retear (P = .878) were not related to a poor prognosis. Also, further analysis showed that posterior (P = .006) and anterior (P = .003) sagittal extent of the retear were related to rotator cable involvement.
An increased AP retear size and decreased AHD were radiological parameters that were associated with poor clinical outcomes after a retear. In particular, patients who had posterior and anterior sagittal extent of the retear, possibly with rotator cable involvement and more severe fatty degeneration of the infraspinatus tendon, showed worse outcomes.
To identify radiological factors that influence the prognosis after a retear.
Case-control study; Level of evidence, 3.
A total of 51 patients with retears confirmed by magnetic resonance imaging at 1 year after arthroscopic rotator cuff repair with a minimum follow-up of 24 months were enrolled in this study. Patients were divided into 2 groups according to whether they achieved the minimal clinically important difference for clinical outcome measures. Range of motion and radiological variables, including preoperative and postoperative anteroposterior (AP) and mediolateral (ML) tear sizes, sagittal extent of the retear, acromiohumeral distance (AHD), and degree of fatty degeneration, were analyzed using magnetic resonance imaging.
Overall, 36 patients were allocated to the good prognosis (GP) group and 15 to the poor prognosis (PP) group. The 2 groups had no significant differences in baseline demographics and preoperative radiological parameters. Postoperative range of motion was decreased in the PP group at the last follow-up. The AP and ML retear sizes decreased in both groups after arthroscopic rotator cuff repair, but the retear size was significantly larger in the PP group (both P < .05). The AHD increased in the GP group (P < .001) but decreased in the PP group (P = .230) postoperatively. Logistic regression analysis revealed that postoperative AHD (P = .003), fatty degeneration of the infraspinatus tendon (P = .001), posterior (P = .007) and anterior (P = .025) sagittal extent of the retear, and change in the AP tear size (P = .017) were related to poor outcomes after a retear. However, change in the ML tear size (P = .105) and middle sagittal extent of the retear (P = .878) were not related to a poor prognosis. Also, further analysis showed that posterior (P = .006) and anterior (P = .003) sagittal extent of the retear were related to rotator cable involvement.
An increased AP retear size and decreased AHD were radiological parameters that were associated with poor clinical outcomes after a retear. In particular, patients who had posterior and anterior sagittal extent of the retear, possibly with rotator cable involvement and more severe fatty degeneration of the infraspinatus tendon, showed worse outcomes.
摘要：
未经证实：肩袖修复后的再撕裂是一个常见问题；然而，与再撕裂后的预后相关的信息很少。此外,一些患者的再泪液有令人满意的结果，这就提出了一个问题，即再撕裂是否会导致预后不良。
UNASSIGNED：确定影响再撕裂后预后的放射学因素。
未经评估：病例对照研究；证据水平，3.
UNASSIGNED：本研究共纳入51例关节镜肩袖修复术后1年经磁共振成像证实存在再撕裂的患者，至少随访24个月。根据患者是否达到临床结果指标的最小临床重要差异，将患者分为2组。运动范围和放射变量，包括术前和术后前后（AP）和中外侧（ML）撕裂大小，再撕裂的矢状范围，肩关节距离(AHD),和脂肪变性的程度，使用磁共振成像进行分析。
未经评估：总的来说，36例患者分为预后良好（GP）组，15例分为预后不良（PP）组。两组在基线人口统计学和术前放射学参数方面没有显着差异。PP组在末次随访时术后活动范围降低。关节镜下肩袖修补术后两组AP和ML再撕裂大小均减少，但PP组的再撕裂尺寸明显更大（均P<0.05）。术后GP组AHD升高(P<.001),PP组AHD降低(P=.230)。Logistic回归分析显示术后AHD(P=.003),冈下肌腱脂肪变性（P=.001），后（P=.007）和前（P=.025）重新撕裂矢状范围，AP泪液大小的变化（P=0.017）与再撕裂后的不良结局相关。然而,ML泪液大小(P=.105)和再次泪液中矢状范围(P=.878)的变化与不良预后无关.此外，进一步分析显示，后（P=.006）和前（P=.003）矢状面范围的再撕裂与旋转电缆受累有关。
UNASSIGNED：AP再撕裂大小增加和AHD减少是放射学参数，与再撕裂后不良临床结果相关。特别是,有前后矢状范围的患者，可能涉及旋转索和更严重的冈下肌腱脂肪变性，显示出更糟糕的结果。
UNASSIGNED：确定影响再撕裂后预后的放射学因素。
未经评估：病例对照研究；证据水平，3.
UNASSIGNED：本研究共纳入51例关节镜肩袖修复术后1年经磁共振成像证实存在再撕裂的患者，至少随访24个月。根据患者是否达到临床结果指标的最小临床重要差异，将患者分为2组。运动范围和放射变量，包括术前和术后前后（AP）和中外侧（ML）撕裂大小，再撕裂的矢状范围，肩关节距离(AHD),和脂肪变性的程度，使用磁共振成像进行分析。
未经评估：总的来说，36例患者分为预后良好（GP）组，15例分为预后不良（PP）组。两组在基线人口统计学和术前放射学参数方面没有显着差异。PP组在末次随访时术后活动范围降低。关节镜下肩袖修补术后两组AP和ML再撕裂大小均减少，但PP组的再撕裂尺寸明显更大（均P<0.05）。术后GP组AHD升高(P<.001),PP组AHD降低(P=.230)。Logistic回归分析显示术后AHD(P=.003),冈下肌腱脂肪变性（P=.001），后（P=.007）和前（P=.025）重新撕裂矢状范围，AP泪液大小的变化（P=0.017）与再撕裂后的不良结局相关。然而,ML泪液大小(P=.105)和再次泪液中矢状范围(P=.878)的变化与不良预后无关.此外，进一步分析显示，后（P=.006）和前（P=.003）矢状面范围的再撕裂与旋转电缆受累有关。
UNASSIGNED：AP再撕裂大小增加和AHD减少是放射学参数，与再撕裂后不良临床结果相关。特别是,有前后矢状范围的患者，可能涉及旋转索和更严重的冈下肌腱脂肪变性，显示出更糟糕的结果。
